Delaying fibroid treatment can lead to long-term complications. Women with fibroids often delay having surgery due to the advice of their doctor, but watching and waiting is an out-of-date practice.

Fibroids are a common GYN condition that affect more than 80 percent of women by age 50. Many women with fibroids have no symptoms, but for those who experience heavy bleeding, pelvic pain, or bloating, treating fibroids as soon as possible can be crucial.

Ignoring the symptoms or delaying fibroid treatment can lead to long-term complications, including anemia, infertility and problems with the kidneys, bowel, bladder or circulatory systems.

• Anemia can result from excessive blood loss. Anemia is the result of deficiencies in the blood, or the body’s inability to produce enough red blood cells. Anemia can cause fatigue, weakness, shortness of breath, heart problems and headaches.
• Infertility can be caused by the location of fibroids or by a fibroid growing simultaneously with a pregnancy, fighting for space and blood supply.
• Kidney damage, or nephrosis, can be the result of fibroids pressing against the ureter, blocking the drainage of urine into the bladder from the kidneys.
• Bowel, bladder or circulatory problems may result from large fibroids taking over space in the pelvic cavity, blocking the normal flow of these systems.

Despite the risks, there are several reasons women ignore heavy bleeding or pelvic pain.

• The normalization of period-related discomforts can lead women to dismiss symptoms as something they have to simply live with. When symptoms move from discomfort into something more disruptive, it’s time to consult a specialist.
• OBGYNs advise patients to wait on treatment. Watching and waiting to treat fibroids has become a standard practice of OBGYNs when patients report problems. This watch and wait advice often leads to fibroids growing, increased bleeding, bloating, pelvic pain, and the risk of the complications listed above.

WHEN TO CHALLENGE THE ADVICE OF YOUR OBGYN

Watching and waiting to treat fibroids is an out-of-date practice. Treating fibroids early is important for preserving fertility, as well as for treating the source of anemia. Laparoscopic myomectomy is the preferred approach for treating fibroids while maintaining fertility. For many OBGYNs, the difficulty in treating fibroids effectively is due to the lack of advanced skills required to perform laparoscopic removal, either as a myomectomy or a hysterectomy.

Patient volume matters to ensure laparoscopic fibroid procedures are performed with expertise. In many cases, OBGYNs have a low volume of surgeries that are performed each year, and as a result, only perform open procedures.

Due to the large incisions and long recovery times, OBGYNs who are only able to perform open surgery will often encourage the watch and wait approach, delaying treatment because of the possible risks to the patient. Similarly, physicians with limited laparoscopic training who use robotics to perform these procedures often do not have the patient volume to develop the skills needed for an effective and thorough surgery. In some cases, there is the risk of a robotic fibroid removal procedure converting to an open procedure, leaving the patient with a longer recovery time and more pain.

It is essential that women who are suffering from fibroids and who are told either to watch and wait, or that their only options for surgery are open or robotic, need to get a second opinion.